The healthcare system in Spain

Spain is divided into 17 autonomous communities including the North African regions, the Canary Islands and the Balearics. The healthcare system was historically controlled by the central government, but today each region takes individual responsibility and the only jurisdiction the central government has is for the overall budget. The Spanish National Health System has an extensive network of health centres and hospitals throughout the country which offer primary health care services (family/GP services, paediatrics and nursing, with midwives, physiotherapists and social workers). The Spanish health system combines both public and private healthcare and within each separate state free or low cost health care is given to those who contribute to the Spanish Seguridad Social (social security).

Healthcare facilities

Health centres in Spain are located within 15 minutes of any place of residence and if necessary a patient can be seen at their own home. In rural areas and in small villages there are local surgeries open on certain days with visits from healthcare staff from the region. Hospitals offer specialised attention, with access via referral from primary healthcare services. There are also Accident and Emergency services available at hospitals and some health centres, and more information can be found at the Ministerio de Sanidad y Consumo website (the Ministry of Health).

Although there are waiting lists for operations in the Spanish health services, they are not as long as in the UK, and there is less of a queue because many people choose private healthcare instead, relying on the national health system just for emergencies. Generally speaking the country's medical facilities are considered good. Many doctors and nurses speak English and most hospitals and clinics in tourist areas provide interpreters. However, as the country is split into different regions, availability of services does vary, which means you could need to travel to a different area for treatment if the facilities are not available locally.

In 1998 the Sistema Sanitario Público (public health service) brought in an official mandate for both doctors and patients outlining the service to which they are entitled and this is listed in all doctor’s offices in a leaflet entitled Carta de Derechos y Deberes (Charter of Rights and Obligations). Doctors in Spain are as highly qualified as in any other EU country, sometimes more so and under the Carta de Derechos y Deberes residents choose their own doctor and health care centre (Centro de Salud).

The institution in charge of healthcare control is the Ministerio de Sanidad y Consumo. The ministry checks all relevant paperwork including qualification certificates and personal background of all surgeons and doctors, and this is the case for all medical personnel from other countries who want to work in Spain. To practise medicine in Spain doctors must be registered with the relevant Medical Association in their individual province. A third of hospitals in Spain are independent and as the state system does suffer with waiting lists many people buy private health insurance and there is a plethora of private hospitals, particularly in the Costa del Sol, which boasts some of the best in the world. There are many advantages to private healthcare in Spain, like a wider choice of medical practitioners and hospitals, the reassurance of being treated by English-speaking professionals, and not least, privacy in the hospital with little or no waiting time.

Care of the elderly

Retiring completely or seasonal retirement (eg winter months) is very popular in Spain. In 2004, there were 150,000 foreign residents over 65, including some 40,000 Britons. However, because Spain is a very family orientated country there are few retirement homes as the elderly are looked after by their families. Consequently, many Brits return to the UK if they are unable to look after themselves when they are elderly.

However, "retirement resorts" and care homes are being developed in Spain to care specifically for elderly expatriates.